# WAVE PHYSICAL THERAPY, INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932291002
- **Authorized official:** MS. NICOLE RENEE BERGER MSPT (OWNER)
- **Authorized official phone:** (423) 227-0386

## Contact information

- **Practice address:** 4204 BENTON DR, CHATTANOOGA, TN 37406-1256
- **Practice address phone:** (423) 227-0386
- **Mailing address:** 4204 BENTON DR, CHATTANOOGA, TN 37406-1256
- **Mailing address phone:** (423) 227-0386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251P0200X | Pediatric Physical Therapist | 5322 | TN | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 08/22/2020